Journal of The Showa University Society

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Volume 81 (2021) Issue 3 Pages 242-249

Measurement of 0-angle on pelvic radiographic imaging for the prediction of delivery prognosis and visualization of station±0 on translabial ultrasonography

Bunbu Sekiya, Ryu Matsuoka, Hiroko Takita, Tatsuya Arakaki, Mayumi Tokunaka, Syoko Hamada, Tomohiro Oba, Masamitsu Nakamura, Yuko Miura, Kazuhiro Hirose, Yasuhiro Sanai, Akihiko Sekizawa

The purpose of this study was to develop a method for visualizing the position of station±0 on translabial ultrasonography and to investigate its relationship with delivery outcomes. By using 501 pelvic sagittal section radiography images of Japanese pregnant women with a singleton fetus in the normal cephalic position at 35–39 weeks, the straight line connecting the projected ischial spine and inferior margin of the pubis was used as the plane of station±0, and the angle between this line and the long axis of the pubis was defined as the 0-angle. The intra- and inter-examiner errors of 0-angle were calculated, and the relationship between the 0-angle and maternal background factors （age, height, body mass index, and weeks of imaging） and the prognosis of delivery （cesarean section, frequency of instrumental delivery, and time required for delivery） was examined. The mean±standard deviation of the 0-angle was 118.9°±5.9°, with a normal distribution, and the intraclass correlation coefficients of the intra- and inter-examiner errors were 0.973 （95％ confidence interval ［CI］：0.950-0.986） and 0.967 （95％ CI：0.938-0.982）, respectively. None of the maternal background factors correlated with the 0-angle. The 0-angle in the cesarean section group was significantly smaller than that in the vaginal delivery group （119.1°±6.0° vs. 116.9°±5.1°）, especially in the cesarean section group （119.1°±6.0° vs. 115.9°±4.5°）. The 0-angle is a highly reproducible and versatile index that is independent of maternal body size. The 0-angle was significantly smaller in the group with delivery arrest, indicating that a shallow pelvic inlet surface tends to cause poor infant head descent. In addition, we visualized station±0 using 0-angle translabial ultrasonography, which can objectively evaluate the degree of infant head descent.

Volume 81 (2021) Issue 3 Pages 229-241

Neuroanatomical correlates of social anxiety in autism spectrum disorder: A preliminary study with voxel-based morphometry analysis

Yosuke Sawanobori, Osamu Takashio, Ryuichiro Hashimoto, Wakaho Hayashi, Mutsumi Kojima, Eriko Ono, Takashi Nishio, Keisuke Aoyagi, Haruhisa Ota, Takashi Itahashi, Akira Iwanami

Social anxiety is a major co-occurring condition in individuals with autism spectrum disorder （ASD）; however, its neuroanatomical basis remains understudied. We examined the neuroanatomical correlates of social anxiety in adults with ASD and compared them in adults with neurotypical control （NC）. The subjects were 40 men with a Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition-Text Revision diagnosis of ASD who were recruited from among the outpatients at Showa University Karasuyama Hospital and 43 neurotypical men without any mental disorders. The subjects’ sociodemographic and clinical characteristics were collected, and the Liebowitz Social Anxiety Scale （LSAS-J）, Autism Spectrum Quotient, and Wechsler Adult Intelligence Scale （Third Edition） were administered to assess the severity of social anxiety, ASD symptoms, and intellectual profiles, respectively. Whole brain 1.5 T magnetic resonance imaging scans were performed. Voxel-based morphometry analysis was used to examine the neuroanatomical correlates of the LSAS-J scores. While the LSAS-J scores were negatively and positively correlated with the gray matter density （GMD） in the sensorimotor cortex and the left superior temporal gyrus in the ASD group, respectively, it had a negative and positive correlation with GMD in the left putamen and bilateral frontal pole, respectively, in the NC group. Adults with ASD have distinctive neuroanatomical correlates of social anxiety compared with their neurotypical counterparts, possibly because of different compensatory mechanisms for heightened social anxiety. These findings shed light on the unique nature of social anxiety in ASD; however, further studies with larger samples that perform a direct comparison between subjects with ASD and NC are warranted.

Volume 81 (2021) Issue 4 Pages 355-362

Kruppel-like factor 4 expression and clinical outcomes in patients with esophageal squamous cell carcinoma

Tetsuya Kitajima, Genshu Tate, Tasuku Nagumo, Sakiko Miura, Mayumi Honma, Eisuke Shiozawa, Masahiko Murakami, Masafumi Takimoto, Toshiko Yamochi

Kruppel-like factor 4 （KLF4） is a transcriptional factor that is widely found in various human tissues. In previous studies, the dual-purpose of KLF4 has been identified – it can function either as a tumor suppressor or as an oncogene in cancer, based on its cellular context. However, there are few reports on the relationship between KLF4 expression and esophageal squamous cell carcinoma （ESCC）. In this study, we aimed to elucidate the role of KLF4 in the pathogenesis of ESCC. We included patients with ESCC who underwent subtotal esophagectomy between 2016 and 2017 at the Department of Surgery, Division of Gastroenterological Surgery, Showa University School of Medicine. We retrospectively analyzed the correlations between KLF4 or p53 expression and the patient’s clinicopathological features. In this study, 88 patients were included. The proportion of KLF4-positive cells was high in the normal esophageal mucosa tissue and low in the ESCC tissue （88.6％［78/88］ vs 51.1％［43/88］）, and this difference in KLF4 expression was statistically significant. In patients with lymphatic metastasis or invasive carcinoma, KLF4 expression levels were low and significantly lower than in those without lymphatic metastasis or invasive carcinoma. In contrast, there were no significant correlations between p53 expression levels and clinicopathological features. In this study, we found several correlations between the expression of KLF4 and histological grade of ESCC; a low expression of KLF4 is associated with advanced ESCC. This suggests that KLF4 acts as a tumor suppressor in ESCC.

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2023 Volume 83 Issue 5

Practice and future prospects for speech-language therapy in acute care hospitals Chisato Ichinoseki, Yoshiko Takei
De-escalating treatment for primary breast cancer Naoki Hayashi
Breastfeeding support for a puerperal with COVID-19: a case report Rieko Mikami, Aya Mineo, Yoshimi Kawashima, Yukiko Miyata, Kunie Ueda
Transaction of The Showa University Society : The 390^th Meeting

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